Active NPI
Srikanth Papisetti, DDS
- General Practice Dentistry
- Lubbock, TX
National Provider Identifier
1649525171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11810
- Practice address
- 2402 19TH St
Lubbock, TX 79401-4414 - Phone
- (888) 988-4066
- Fax
- (847) 496-7603
- NPI assigned
- Jul 20, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 28263 | TX | |
| General Practice Dentistry | 1223G0001X | 11810 | CT | Primary |
Addresses
Primary practice location
2402 19TH St
Lubbock, TX 79401-4414
Mailing address
2050 E Algonquin Rd
Suite 610
Schaumburg, IL 60173-4144
Phone (888) 988-4066
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11810 | CT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familia Dental Lubbock PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496793600000",
"number": "1649525171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050 E ALGONQUIN RD",
"address_2": "SUITE 610",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601734144",
"telephone_number": "888-988-4066",
"fax_number": "847-496-7603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2402 19TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794014414",
"telephone_number": "888-988-4066",
"fax_number": "847-496-7603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAPISETTI",
"first_name": "SRIKANTH",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-20",
"last_updated": "2017-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "28263",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "11810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.